Video: Did Michelle Obama start a patient-dumping program?

posted at 9:27 am on July 23, 2009 by Ed Morrissey

While Barack Obama presses for health-care reform, Sean Hannity looks at his wife’s efforts to reform medical care at the University of Chicago Medical Center as its vice-president. In a lengthy segment on last night’s show, Hannity reports on the Urban Health Initiative, a program ostensibly intended to provide the kind of change in health care that President Obama says his program will deliver nationally — fewer emergency room vists, better wellness and prevention care, and lower costs. However, the people in Chicago see the UHI differently. In practice, it looks more like a patient-dumping scheme to avoid dealing with Medicare/Medicaid patients (via HA reader JiangxiDad):

This came up during the presidential campaign, but just as the conventions and running-mate selection picks had the media blinkered. The Chicago Sun-Times reported on it August 23rd, 2008:

Sen. Barack Obama’s wife and three close advisers have been involved with a program at the University of Chicago Medical Center that steers patients who don’t have private insurance — primarily poor, black people — to other health care facilities.

Michelle Obama — currently on unpaid leave from her $317,000-a-year job as a vice president of the prestigious hospital — helped create the program, which aims to find neighborhood doctors for low-income people who were flooding the emergency room for basic treatment. Hospital officials say such patients hinder their ability to focus on more critically ill patients in need of specialized care, such as cancer treatment and organ transplants.

Obama’s top political strategist, David Axelrod, co-owns the firm, ASK Public Strategies, that was hired by the hospital last year to sell the program — called the Urban Health Initiative — to the community as a better alternative for poor patients. Obama’s wife and Valerie Jarrett, an Obama friend and adviser who chairs the medical center’s board, backed the Axelrod firm’s hiring, hospital officials said.

Another Obama adviser and close friend, Dr. Eric Whitaker, took over the Urban Health Initiative when he was hired at U. of C. in October 2007. Whitaker previously had been director of the Illinois Department of Public Health. Obama has said he recommended Whitaker for the state job, giving his name to Tony Rezko, who helped Gov. Blagojevich assemble his Cabinet. Rezko, a former fund-raiser for Obama and Blagojevich, was convicted in June on federal corruption charges tied to state deals.

U.S. Rep. Bobby Rush (D-IL) is calling on the House Committee on Oversight and Government Reform to investigate allegations that the University of Chicago Medical Center is practicing patient dumping, an illegal act where hospitals divert poor or uninsured patients to other hospitals.

“As an institution that receives federal funds, I am concerned about recent media reports that allege the medical center is turning away and refusing treatment to low-income, uninsured patients,” Rush said in a letter to U.S. Rep. Edolphus Towns (D-NY), the committee chairman.

Rush, who called patient dumping “a widespread problem” in American health care, said he might move to lift the hospital’s federal funding if it turns out the allegations are true.

The people of the community seem pretty convinced that UHI intended on keeping poor people out of the UCMC, as these reports and others show.

What I find most interesting about this is that the three people in the White House behind UHI have shown a remarkably low profile on the push for ObamaCare. Could it be that Obama and his staff worry that this will derail the effort, and have kept the trio out of the debate deliberately?

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Update (Michelle): FYI, I reported on Michelle Obama’s health care horror story you won’t hear about on June 19 and have a detailed section on the patient-dumping scheme in Chapter 2 of Culture of Corruption.

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Hope you never get sick and need a six figure liver transplant, my darling. You’d be dead.

mjk on July 23, 2009 at 10:49 AM

No, darling, but I’ve worked hard since elementary school, through high school and college, and through graduate school to make sure that I can purchase private health insurance.

Sorry, but pricy private hospitals won’t be able to provide better quality care than public institutions if they are forced to fill themselves with non-paying recipients of public aid.

How bizarre to see conservatives take on the argument that cadillac quality medical care is an inalienable right, not a commodity that one can purchase if one has worked hard to earn enough money to purchase it.

And how bizarre to see conservatives calling for equal misery for all rather than allowing private, high quality hospitals that provide a higher standard of care and furnishing to exist … the public hospitals are sufficient to provide care to medicaid recipients, and that’s where medicaid recipients should be treated.

which begs the question: If these ‘senior executive jobs’ at UCMC at which Michelle Obama ‘worked’ at were cut, and since UCMC claimed that cutting those sr. exec. positions wouldn’t effect health care, why should any hospital have those positions in the first place?

THIS is how we get to the point of being charged mega$$ for an asprin at hospitals – if you can get it. Hardly the cost savings Obama claims.

There are already facilities that can handle these kinds of cases, so there’s no need for the UCMC to build yet another one. It’s a whole lot cheaper to pay cab fare to send non-emergent cases elsewhere than to build a new office complex/medical clinic.

Honestly, if we’re talking about ambulatory patients who came into a level 1 trauma center with minor complaints, those folks will be better served in a community clinic. They can perhaps even establish a bit of a relationship/history with a medical clinic that way, which makes it easier to track medical history and medications. The ER is not set up to do that, but small community clinics are.

And if UCMC is sending folks for inpatient care at public hospitals when they don’t have insurance or have government insurance, that’s also appropriate since we have public hospitals that get lots of money from local, state, and federal governments to provide inpatient care to poor people. The public hospitals don’t have fancy rooms and new paint on the walls, and don’t have private bathrooms attached to each patient room sometimes, but the quality of care is fine.

the public hospitals are sufficient to provide care to medicaid recipients, and that’s where medicaid recipients should be treated.

According to the annual report they recieved 35 million in 2007 from the state medicaid fund. This was payment for 2 years worth, because 2006 had been held up for some reason, pending federal approval.

I’m sure there was a reason why the money was held up, and why it was ultimately released, by I won’t speculate.

And if UCMC is sending folks for inpatient care at public hospitals when they don’t have insurance or have government insurance, that’s also appropriate since we have public hospitals that get lots of money from local, state, and federal governments to provide inpatient care to poor people

If these ’senior executive jobs’ at UCMC at which Michelle Obama ‘worked’ at were cut, and since UCMC claimed that cutting those sr. exec. positions wouldn’t effect health care, why should any hospital have those positions in the first place?

heroyalwhyness on July 23, 2009 at 11:17 AM

YES, this is a much, much better line of attack. MO’s job was classic waste, fraud, and abuse…but not because she sought to redirect patients to appropriate facilities.

And the tort reform issue as well, of course.

Y’all really should consided that most of you are clamboring to team up with Bobby Rush against a quality private entity. The fact that the quality private entity found it lucrative to slip $$$$ into a dirty Chicago politician’s pocket is a problem, but sadly that problem is separate from the issue of re-directing patients to more appropriate settings for their medical treatment.

I’m sure there was a reason why the money was held up, and why it was ultimately released, by I won’t speculate.

reaganaut on July 23, 2009 at 11:23 AM

Ah, sadly, one can’t draw a lot of conclusions from the fact that their medicaid dollars were held up. Medicare and medicaid are classic big government programs, meaning that their decisions usually don’t make sense. My Mom spent lots of time fighting medicare and medicaid to get them to pay the hospital for treatment. Their first response in the majority of cases was to deny the claim and force the hospital to jump through hoop after hoop to get their money. THAT is why we don’t want single payer “health care” … you think HMOs are hard to deal with?

My mom also spent a ton of time attempting to educate doctors so they would stop admitting medicare and medicaid patients for stuff that didn’t require it. That was the biggest issue–medicare and medicaid don’t want to pay private hospitals for inpatient care. Doctors were admitting every medicare patient who came to the ER with the flu, and the hospital was losing tons of money. Also, doctors were admitting drug addicts who showed up in the ER with “pain” issues for full work-ups.

Of course most of it was due to fears of being sued….

Hospitals and doctors really are in a very tough position, especially when so many people assume that welfare recipients are entitled to gold-plated medical care.

Are we next going to provede welfare recipients housing in the Trump Towers penthouses?

this has been known by those of us who bothered to try to find out who this unknown black politician from chicago with no record but a meteoric rise and his wife with the 300+K cushey payoff job for favors were during the primaries and the election.

Sadly this information would have raised too many questions about ethics and PAY FOR PLAY which since Obama said he doesn’t do, snicker, the press said ok and didn’t bother to push the story.

Nope. The point of the article and the thread is that so many people are willing to jump on Bobby Rush’s outrageous outrage bandwagon that recipients of goverment aid are being redirected to facilities that are established to provide care to them instead of getting cadillac quality care at a premier private institution.

Trust me, if providing care to medicaid patients in the ER or as inpatients served the private hospital’s bottom line, the private hospitals would be competing to get those patients. Here’s a comment from the other thread that is applicable over here too:

Why are conservatives so anxious to demonize a private entity that is trying to make a profit?

Ed’s post reminds me that I first saw this “health initiative” described simply as a program to hook people up with a primary-care physician. Michelle O of course got the credit for starting it.

Thing is, I have never seen anywhere, anytime, any other mention of anything else Michelle ever did in her $300,000+ job.

Surely for this salary she had other duties. I’ve just never seen anything but this Urban Health Initiative identified as something she did in her position.

Full disclosure: Unlike some people, I’ve always had a problem with Michelle’s cushy job and her salary, because she was making about twice as much as my daughter-in-law, who is a pediatric oncologist. Needless to say, she doesn’t have very many good days at the office.

The point of the article and the thread is that so many people are willing to jump on Bobby Rush’s outrageous outrage bandwagon that recipients of goverment aid are being redirected to facilities that are established to provide care to them instead of getting cadillac quality care at a premier private institution.

No it isn’t. That might be your interpretation.

Why are conservatives so anxious to demonize a private entity that is trying to make a profit?

Private entity that collected 62 million taxpayer dollars while dumping patients they didn’t want. That doesn’t include the earmarks and grant money given to the med school.

They “collected” that money by billing medicaid for patient care. Medicaid and medicare work just like private insurance. A patient comes in for treatment, and the hospital bills for the treatment.

If treating medicaid patients covered the hospital’s expenses and provided a profit margin, hospitals would be thrilled to treat medicaid patients. The fact is that medicaid reimbursements don’t cover expenses in fancy private institutions that spend lots of money on esthetic and other areas to provide a higher quality patient experience.

You are arguing that private hospitals should be forced to pay out of pocket to provide Cadillacs for folks whose insurance plan only pays for a Yugo, when there is a Yugo dealership down the street. Of course the Yugo folks want to get their free Cadillac….but the end result will just be that the Cadillac dealer goes belly up giving away all those high-end cars.

Here I thought that Michelle was being forced as first lady to be a behind the scenes player–guess she was always one.Still maintain that the Michelle of the campaign is the real one and sooner or later that gal is going to show up again.

Think this would be getting any coverage if a Laura Bush or Cindy McCain was involved? (file this question in the stupid questions pile)

rockhead on July 23, 2009 at 12:41 PM

Of course it would be all over the news…but it would be BS, and conservatives would be able to recognize it as such….demonization of a private company’s attempt to stay in business and perhaps even turn a profit.

Attach it to MO, and it’s suddenly an outrageous outrage that Bobby Rush’s deadbeat race-baiting constituents can’t get the same medical care as productive members of society.

Now, do I think MO’s experience is going to help inform Obamacare? snort…no way. I certainly don’t expect the community organizer in chief to countenance that other private hospitals should be allowed to turn a profit or turn away indigent patients.

More to the point: How much is the hospital paying Michelle’s replacement?
mojo on July 23, 2009 at 11:13 AM

My recollection is that they did not replace her, ostensibly as part of the University’s cost-cutting efforts.

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In terms of this program, I think that the idea of trying to encourage people who do not need urgent care to go to local doctors and clinics is a good one. I remember waiting at the U of C emergency room when I cut myself in the lab and it was packed with people who sure didn’t seem to have injuries or acute illnesses. Unfortunately, from what MM has posted, particularly the story about the child with the severe dog bite injury (that required surgery), it looks like they abused the program.

Although I loathe Michelle Obama with the red hot intensity of a thousand suns, I think there is a chance, however remote, that the program that she helped design was intended to help people find regular care for their chronic illnesses… but that in the implementation the program was used to dump patients.

We can since she didn’t try to stop it either or, apparently, research it’s ramifications. That part must have been above her pay grade?

jeanie on July 23, 2009 at 1:17 PM

How many instances of emergent patients being dumped were there? I only read about the kid with the dog bite. Were there a lot of other instances? How many went into formal complaints against the med center during her time there?

Don’t get me wrong, I loathe her and am ashamed of the U of C for such a blatant act of nepotism in hiring her, but as VP for Community Relations or whatever her title was, I doubt she held much sway over the Dean of the Med School and the other docs and administrators who would have been more involved in the implementation of the program.

I know I’m probably too stupid to figure this out correctly but if you have a problem with people using the emergency room for non-emergency room illnesses that a primary doctor could handle, $150 vs $1000 that’s been noted, then WHY not set up a primary care clinic AT the hospital that those patients could go to. Seems like a clinic of doctors would PAY for a steady stream of patients or the hospital could make the profit.

Jeff from WI on July 23, 2009 at 10:29 AM

Because they are not paying or are on some sort of Medicaid. And city hospitals in NYC have had clinics for over 30 years but people will still try to get seen in the ER because they don’t want to wait to be seen at a clinic. Now, that was back when a clinic wait was longer than an ER wait. But, you see the problem.

Still, she cannot masquerade as a friend of the needy classes if she was in any kind of position to monitor this program, which it seems she did not even though she was in a position to do so. It’s nice you’re so kind about it, but she’ll never be off the hook as far as I’m concerned. As far as is known she is not on record as having spoken up or making any effort to ascertain the results of this policy. Michelle O. seems(so far) unable to follow through on much that she does or says except, possibly, her fashion statements. Will agree that this is old news and probably not provable.

I don’t know what one can reasonably expect a hospital to do if it considers itself overburdened by people who can’t pay or can’t pay enough to allow the hospital to thrive. It seems especially absurd to expect a hospital to stand pat, if the patients are impairing the work of the Emergency Department. Based on the description here, readers should take note that it seems Sean Hannity and Ed Morrissey are attacking Michelle Obama and the University of Chicago Medical Center from “the left; UCMC business model wasn’t socialist enough to suit them.

I just read that Obama’s Wednesday night criticism of the Cambridge, Massachusetts police has drawn a rebuke from the Fraternal Order of Police, and now this.

Both Barry and Michelle are despicable human beings. Obama is not fit to lead, in any capacity. After reading this story about Michelle Obama’s cruelty and total disregard for the downtrodden in Chicago, during the most vulnerable times, in their lives, Mr. Obama must not be permitted to touch our present health care system. He’s a Chicago gangster who has been afforded the opportunity of playing the role of President of the United States. He’s having a great time, like a kid in a candy store.

I hope Hannity and other hosts on Fox News keep the “Patient Dumping” story alive for all Americans to evaluate.

I think your missing their point- Michelle and UCMC made a stategic decision to send patients away that COULDN’T pay or THE REIMBURSEMENT(by the governement medicare) WASN’T SUFFFICIENT to cover costs. NOW, under OBAMACARE they want ALL OF US to have a plan where the GOVERNMENT dictates how much they will reimburse the hospital/doctor/clinic for care and HOSPITALS and DOCTORS are saying its going to make matters WORSE.

And that HOUSE BILL has a statement in it that says the Health Care Coordinator after 18 months of the plan going into effect and studying it -WILL MAKE SURE THERE IS NO INCENTIVE FOR A BUSINESS TO SELF INSURE. I read it. It is in there.

It is IRONIC that Michelle and Obama want us to go to a government plan that will bankrupt hospitals with underpayment when she was the driving force rescuing UCMC from having an imbalance of non paying/low paying vs fully covered patients.

Hard to tell whether it’s a patient dumping scheme or a prudent program to divert non-emergency patients to non-emergency care, thus saving the hospital a lot of money and time.

Infidoll on July 23, 2009 at 12:48 PM

Not so hard at all: They were taking/billing the insured (aka people with money) and ‘dumping’ the poor people. There are questions as to how much federal tax subsidies (to treat the poor) vs. how much they spent treating the poor. They took the money and dumped the poor patients, and didn’t dump the ‘paying customers’.

They should also investigate the huge cost (waste) in michelle obama’s salary: She got like a 100% raise when barack became a us senator; he directed millions to the hospital…

oh, and one should never, ever use the word ‘prudent’ when describing a government-run program! :)

1)What percentage of those low income patients were from the SURROUNDING community?
2)Did those patients walk to the hospital or did they have a car? (they are being bussed to diff hospitals so I am assuming that they walked or were given rides by friends)
3)Are the hospitals that were forced to take these patients in BETTER or WORSE financial condition now because the reimbursement rate of Medicare didn’t cover the treatment? This one is huge because if they are failing now with these patients how many hospitals are going to go under when we are all on government health insurance and they dictate the reimbursement rate?

journeyintothewhirlwind on July 23, 2009 at 10:59 AM

Read the link above (update; June 19) from michelle malkin.com It’s a good read – be sure to follow her links.

In February 2009, outrage in the Obamas’ community exploded after a young boy covered by Medicaid was turned away from the University of Chicago Medical Center. Dontae Adams’ mother, Angela, had sought emergency treatment for him after a pit bull tore off his upper lip. Mrs. Obama’s hospital gave the boy a tetanus shot, antibiotics, and Tylenol and shoved him out the door. The mother and son took an hour-long bus ride to another hospital for surgery